The mini-gastric bypass or one anastomosis gastric bypass (MGB-OAGB) is now growing rapidly in popularity as a safe and effective procedure, with excellent control of weight and co-morbidities in long-term evaluations. Worldwide, it seems to have an important place in the bariatric armamentarium, being better or, at least, as good as the Roux-en-Y gastric bypass (RYGB).
However, there are some significant clinical issues. “Biliary reflux”, “marginal ulcer” or excessive weight loss need better understanding, leading to improved treatment.
We found that by adding a Roux-en-Y diversion to the MGB-OAGB cases which had pathologic post-operative reflux, we were giving patients a very comfortable and effective solution. Thus, in 2013, we decided to do the same in some primary patients who we knew were at risk for gastro-esophageal reflux. We got the same good outcomes.
Diverted mini-gastric bypass (dMGB) is now an established technique in our practice, in about one-third of the patients who receive a gastric bypass. Here we describe the rationale of the concept, the surgical technique and the clinical outcomes of the first 300 patients of our series.
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